صفحه 1:
Ana Maria Henao
World Health
صفحه 2:
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WHO/EPI
صفحه 4:
| One sterile needle
and syringe for
each dose ....
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صفحه 5:
صفحه 6:
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Simonsen et al, Bull WHO 1999
WHO/EPI
صفحه 7:
Injection safety equipment &
Supplies
¢ Ensuring quality
* Increasing access
* Improving knowle
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WHO/EPI programme fd
صفحه 8:
۱ Needles should not
be recapped .....
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صفحه 9:
: Estimated Risk of Infection
33 3096
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Sourgesdvieedlestick injuries studies among healthcare workers
صفحه 10:
* Policy
¢ Integrated,
comprehensive app.
¢ Implementation-pl
¢ Training
¢ Monitoring
WHO/EPI
صفحه 11:
: Be able to rapidly
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immunization
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صفحه 12:
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صفحه 14:
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صفحه 15:
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صفحه 17:
INJECTION SAFETY
Key steps during mass campaigns
Step 4
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WHO/EPI fd
صفحه 18:
INJECTION SAFETY
Key steps during mass campaigns
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صفحه 19:
Responding toveports of AEFI
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صفحه 21:
۰ تاحمحصعوووعم لهتانوز
* National coalition
* Implementation of a three
approach
1- Behaviour change
2- Equipment and supplies
3- Sharps waste management
* Monitoring and evaluation
لدف نينا
صفحه 22:
How to ensure all this ?
* Prepare a work plan
-what, where, when, who ?
* Train
¢ Supervise-monitor
- before - during - after
° Evaluate
Use experience to improve....
WHO/EPI
صفحه 23:
San Francisco Chronicle
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Fast Track to Global Disaster_
صفحه 24:
The Safe Injection Global
Network (SIGN)
Weekly moderated E-mail list server
(sign@who.int)
Internet site (www.injectionsafety.org)
صفحه 25:
A: Caan Xy ا"
New/modified JETI NJECTORS *
AEROSOL vaccination °
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WHO/EPI
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صفحه 26:
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WHO/EPI
Safe Injections
Ana Maria Henao
World Health
WHO/EPI
Every
Everycountry
countryshould:
should:
• ensure the quality & safety of its vaccines
• ensure the safety of immunizations
• be able to rapidly detect
immunization safety issues
• be prepared to effectively deal
with immunization safety issues
when they arise
WHO/EPI
What is the magnitude of the problem ?
• Burden of disease
– HBV infections: 8-16 millions
– HCV infections: 2.3 - 4.7 millions
– HIV Infections: 80,000 to 160,000
• Cost
– 1.3 million future early deaths
– 26 million of years of life lost
– US$535 million direct medical costs
WHO/EPI
Patient with
cirrhosis in Africa
One sterile needle
and syringe for
each dose ….
Not always ensured..!
WHO/EPI
Unsafe practice ?
Injections Administered with an
unsterilized Syringe and/or a Needle
Former socialist
economies of Europe
Middle East crescent
Sub-Saharan Africa
India
China
Other Asia and Pacific
0%
10%
Simonsen et al, Bull WHO 1999
WHO/EPI
20%
30%
40%
Estimated proportion
50%
60%
Injection safety equipment &
Supplies
• Ensuring quality
• Increasing access
• Improving knowledge
Auto-Disable
Syringe
WHO/EPI
By 2001, A-D syringes for
all
injections in routine
programme
Needles should not
be recapped …..
Estimated Risk of Infection
Following a Needlestick from an
Infected Source-Patient
35%
30%
30%
Is the risk higher enough ?
25%
20%
15%
10%
5%
3%
0%
Hepatitis B Virus Hepatitis C Virus
0.30%
HIV
Source:
Needlestick injuries studies among healthcare workers
WHO/EPI
Sharps Waste Management
• Policy
• Integrated,
Is the problem real ?
comprehensive approach
• Implementation-plan
• Training
• Monitoring
WHO/EPI
Children playing
with syringes in Asia
Be able to rapidly
address
immunization
safety issues
Adverse events:
programmatic
error
TT
Insulin vial
WHO/EPI
DTP
Vaccine vials
Mass
Masscampaigns
campaigns
An
Anopportunity
opportunityto
tostrengthen
strengthen
immunization
immunizationsafety
safety??
WHO/EPI
INJECTION SAFETY
Key steps during mass campaigns
Auto-disable syringes should be provided
together with high quality vaccine for ALL
elective and emergency immunization mass
WHO/EPI
campaigns
INJECTION SAFETY
Key steps during mass campaigns
One syringe should be used for each dose administered.
Measles vaccine should be administered subcutaneously
Needles should NOT be recapped.
WHO/EPI
INJECTION SAFETY
Key steps during mass campaigns
Used syringes should be dropped in a safety box or
puncture resistant container immediately after use
WHO/EPI
INJECTION SAFETY
Key steps during mass campaigns
Used disposable and auto-destruct syringes should be stored
in a safe place and incinerated soon after.
WHO/EPI
INJECTION SAFETY
Key steps during mass campaigns
Where will the safety boxes disposed ?
Who is collecting all the safety boxes after the campaign?
How will they be transported ?
Who is going to verify that it happens ?
WHO/EPI
Responding
Respondingto
toreports
reportsof
ofAEFI
AEFI
Media hear first
Crisis situation
Hasty regulatory action detrimental to the
program;
loss of public confidence
WHO/EPI
immunization
WHO/EPI
Injection Safety at Country Level
• Initial assessment
• National coalition
• Implementation of a three-prong
approach
1- Behaviour change
2- Equipment and supplies
3- Sharps waste management
• Monitoring and evaluation
WHO/EPI
How to ensure all this ?
• Prepare a work plan
– what, where, when, who ?
• Train
• Supervise-monitor
– before - during - after
• Evaluate
Use experience to improve….
WHO/EPI
WHO/EPI
The Safe Injection Global
Network (SIGN)
World Health Organization
Weekly moderated E-mail list server
(sign@who.int)
Internet site (www.injectionsafety.org)
In the pipeline………..
Needle - free devices
• New/modified JET INJECTORS
• AEROSOL vaccination
VVM for measles
WHO/EPI
Conclusions
• Injection safety should be considered as a
priority
• Time has come to implement action
Timing has a lot to do
with the outcome
of a rain dance
WHO/EPI